Individual provider Active NPI

Jonathan Vincent Roxas, DDS

  • General Practice Dentistry
  • Portland, OR
National Provider Identifier
1710982830
Registry record updated Oct 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D7827 Issued in OR
Practice address
6227 SE Powell Blvd
Portland, OR 97206-2749
Phone
(503) 777-1332
Fax
(360) 777-9990
NPI assigned
Jun 15, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D7827 OR Primary

Addresses

Primary practice location

6227 SE Powell Blvd
Portland, OR 97206-2749

Mailing address

6227 SE Powell Blvd
Portland, OR 97206-2749
Phone (503) 777-1332

Other names 1

  • Dr. Jon V Roxas Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D7827ORMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317600000000",
    "number": "1710982830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6227 SE POWELL BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972062749",
            "telephone_number": "503-777-1332",
            "fax_number": "360-777-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6227 SE POWELL BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972062749",
            "telephone_number": "503-777-1332",
            "fax_number": "360-777-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROXAS",
        "first_name": "JONATHAN",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2011-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D7827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JON",
            "last_name": "ROXAS",
            "middle_name": "V",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.